Pooling of Chlamydia laboratory tests to determine the prevalence of ocular Chlamydia trachomatis infection

Jonathan Diamant Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Roger Benis Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Julius Schachter Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Jeanne Moncada Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Frankye Pang Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Hem C. Jha Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Ramesh C. Bhatta Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

J.S.P. Chaudhary Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Travis Porco Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

Tom Lietman Francis I. Proctor Foundation and Laboratory of Medicine, University of California, San Francisco, Department of Public Health, San Francisco, California, USA and Geta Eye Hospital, Nepal

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Abstract

With the Global Elimination of Trachoma by 2020 program underway, it has become increasingly important to identify the prevalence of ocular chlamydia infection in communities. DNA amplification tests are the gold standard, but are prohibitively expensive. In the present paper, we investigate whether pooling multiple specimens into a single test is feasible. The conjunctivae of 170 children in western Nepal were examined and swabbed. The prevalence of chlamydial infection was estimated in two ways using the ligase chain reaction: by testing all 170 specimens individually, and by testing 34 pools of 5 specimens each. We show that the confidence interval for 34 pooled specimens approaches that of doing all 170 specimens as the prevalence decreases. We also determine the optimal number of specimens to pool into a single test to minimize the confidence interval of the estimate. If the population prevalence is expected to be around 10%, then 14 specimens should be pooled per test. Even at 50% prevalence, costs can be reduced by pooling two samples per test.

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Pooling of Chlamydia laboratory tests to determine the prevalence of ocular Chlamydia trachomatis infection

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Pooling of Chlamydia laboratory tests to determine the prevalence of ocular Chlamydia trachomatis infection

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